What is video-assisted thoracoscopic surgery?

VATS is a way to do surgery inside the chest. With open surgery, the doctor makes one large cut in your chest. But with VATS, the doctor makes several small cuts. VATS also differs from open surgery because the doctor does not have to cut through the ribs or breastbone (sternum). The doctor can use VATS to find and treat many problems in the chest.

To start, the doctor will make several small cuts between your ribs. These cuts are called incisions. The doctor will put a thin, lighted tube with a camera on it into your chest. This tube is called a thoracoscope, or scope. It lets the doctor see inside your chest. Then the doctor will use tiny surgical tools to do the surgery. The doctor will close the incisions with stitches or staples.

How long you stay in the hospital and how long your recovery takes will depend on why you are having the surgery.

The scars from the incisions will fade with time. The area around the incisions may ache or feel numb in the weeks after surgery.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• Do breathing exercises at home if instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when it is safe to you to drive or fly.
• You will probably need to take at least 1 to 2 weeks off from work. It depends on the type of work you do and the surgery you had.
• You may take showers. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Have your child rest when he or she feels tired.
• Allow your child's body to heal. Don't let your child move quickly or lift anything heavy until he or she is feeling better.
• Have your child do breathing exercises at home if instructed by your doctor. This will help prevent pneumonia.
• Your child can do his or her normal activities when it feels okay to do so.
• Many children are able to return to normal activities within a few weeks after surgery.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• If your child's bowel movements are not regular right after surgery, you can help him or her to avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.

Incision care

• If your child has strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
• You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
• Change the bandage every day.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
• Your child may shower 24 to 48 hours after surgery. Pat the incision dry. Your child should not swim or take a bath for the first 2 weeks, or until the doctor tells you it is okay.

VATS is a way to do surgery inside the chest. With open surgery, the doctor makes one large cut in your child's chest. But with VATS, the doctor makes several small cuts. VATS also differs from open surgery because the doctor doesn't have to cut through the ribs or breastbone (sternum). The doctor may use VATS to find and treat problems with the lungs, heart, or spine. Or the doctor may use it to operate on other organs in your child's chest.

To start, the doctor will make several small cuts between your child's ribs. These cuts are called incisions. The doctor will put a thin, lighted tube with a camera on it into the chest. This tube is called a thoracoscope, or scope. It lets the doctor see inside your child's chest. Then the doctor will use tiny surgical tools to do the surgery. The doctor will close the incisions with stitches or staples.

How long your child stays in the hospital and how long it takes him or her to recover will depend on why your child is having the surgery.

The scars from the incisions will fade with time. The area around the cuts may ache or feel numb in the weeks after surgery.

Video-assisted thoracoscopic surgery (VATS) is a way to do surgery inside the chest using several small cuts (incisions) instead of one larger incision (open surgery). VATS also is different from open surgery because it does not require the doctor to cut through the ribs or breastbone (sternum). The doctor may have used VATS to find and treat problems with the lungs, heart, or spine. Or VATS may have been done to operate on other organs in your chest.

Your chest may be sore where the doctor made the incisions and put in the surgical tools. This usually gets better after 2 to 3 weeks.

You will have stitches or staples in the incisions. Your doctor will take these out 1 to 2 weeks after your surgery.

The amount of time you will need to recover depends on the surgery you had. But you probably will need to take it easy at home for at least 1 to 2 weeks.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, your child's surgery may be canceled. If your doctor told you to have your child take any medicines on the day of surgery, have your child take them with only a sip of water.
• Follow the doctor's instructions about when your child should bathe or shower before the procedure. Do not apply lotion or deodorant.
• Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take about 1 to 3 hours. How long it takes depends on the condition being treated.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery staff will monitor your child's condition. The doctor will talk to you about the surgery.